NEW YORK (Reuters Health) - Men who are found to have had
an unrecognized or "silent" heart attack are at increased risk
of developing dementia or small lesions in the brain that can
affect cognition, Dutch researchers report.

Dr. Monique M. B. Breteler told Reuters Health that her
group had previously found that men, but not women, with a
silent heart attack are more likely to have a stroke than men
who had a recognized heart attack or those who had not had any
heart attack.

To examine whether this might also be the case for dementia
and so-called cerebral small vessel disease, Breteler of
Erasmus University, Rotterdam, and her colleagues examined data
for more than 6300 participants in a population-based study.

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At the start of the study, from 1990 to 1993, the subjects
were classified as having a recognized heart attack, not having
a heart attack, or having had an unrecognized heart attack
based on EKG tracings. They were followed for the occurrence of
dementia, of which there were 613 cases by 2005.

The team also examined data for 436 subjects without
dementia who underwent MRI brain scans.

Compared to men who had not had a heart attack, men with an
unrecognized heart attack were more than twice as likely to
develop dementia. They also had more brain lesions and showed
signs of cerebral blood vessel blockages more often on MRI, the
team reports in the American Heart Association's journal
Stroke.

There were no associations between dementia risk and
unrecognized heart attacks in women, or among men and women
with recognized heart attacks.

The researchers conclude that using an EKG to screen men to
see if they've had an unrecognized heart attack "might identify
those at an increased risk of various adverse outcomes." They
might then benefit from subsequent preventive therapy.

"However," Breteler pointed out, "before such screening can
be initiated, it should first be evaluated for efficacy and
cost-effectiveness in adequately designed randomized controlled
studies."